Abstract
BackgroundThis study aimed to assess the effects of isotretinoin treatment on hirsutism, menstrual cycle and hormonal response in adolescents with acne vulgaris (AV).MethodsIn the study, 76 participants with nodulocystic acne were included. Free testosterone (fT), total testosterone (tT), dehydroepiandrosterone sulfate (DHEAS), luteinizing hormone (LH), follicle-stimulating hormone (FSH), 17-OH progesterone (17-OH PG), and sex hormone-binding globulin (SHBG) levels of the participants were measured before and at the third and sixth months of treatment. Furthermore, the patients were evaluated for hirsutism and menstrual irregularity.ResultsThe rates of menstrual irregularity and hirsutism at the beginning and at the third and sixth months of treatment were found to be different (p < 0.05). fT, tT and DHEAS levels at the third and sixth months of treatment were higher than those at the beginning of treatment, and the SHBG level at the sixth month was found to be lower than that at the beginning and third month of treatment (p < 0.05). The tT levels were found to be lower and DHEAS levels were higher than those at the beginning of treatment in patients who presented with menstrual irregularity at the third month of treatment (p < 0.05). The LH and 17-OH PG levels were noted to be lower and DHEAS levels were higher than those at the beginning of treatment in patients who developed hirsutism at the third month of treatment (p < 0.05). The SHBG levels were observed to be lower and DHEAS levels were higher than those before treatment in patients who developed menstrual irregularity at the sixth month of treatment (p < 0.05). SHBG levels were discerned to be lower and DHEAS levels were higher compared to those at the beginning of treatment in patients who developed hirsutism at the sixth month of the treatment (p < 0.05).ConclusionsIsotretinoin can cause alterations in the adrenal hormone levels. Hirsutism and menstrual irregularity can be observed during treatment follow-ups.
Highlights
Acne vulgaris (AV) is a chronic inflammatory disease of the pilosebaceous unit that usually occurs during adolescence [1]
Hirsutism and menstrual irregularity can be observed during treatment follow-ups
Isotretinoin (13-cis-retinoic acid) is a synthetic vitamin A derivative used in patients with nodulocystic and resistant acne that does not respond to conventional treatments [6,7]
Summary
Acne vulgaris (AV) is a chronic inflammatory disease of the pilosebaceous unit (hair follicles and the associated sebaceous glands) that usually occurs during adolescence [1]. The characteristic lesions include open-closed comedones, inflammatory papules, pustules, nodules, and cysts that can cause the formation of scars. Androgens play an important role in the development and change of sebaceous glands and hair follicles [3,4]. There are limited studies on the metabolic and hormonal effects of isotretinoin, which is a relatively new molecule, on humans, and some of them have mentioned conflicting and new side effects [8]. Hirsutism and menstrual irregularity have been detected during the follow-up of patients who received isotretinoin treatment. This study aimed to assess the effects of isotretinoin treatment on hirsutism, menstrual cycle and hormonal response in adolescents with acne vulgaris (AV)
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